Molina Healthcare · 17 hours ago
Lead Analyst, Quality Analytics & Performance Improvement (Remote)
Arizona, United States
Full-time
Remote
Senior Level, Lead/Staff
$80K/yr - $188K/yr
6+ years exp
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Responsibilities
Work cross functionally with various departments to capture and document requirements, build reporting solutions, and educate users on how to use reports.
Assist Quality Data Analytics Leaders in Predictive Intervention Strategy Analytics along with corresponding tracking of progress and impact of such interventions.
Design and develop retrospective HEDIS rate tracking and supplemental data impact reporting.
Develop Medical Record Review project reporting to track progress and team productivity reporting.
Lead Design and Development of ad-hoc as well as automated analytical as well as Reporting modules related to Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP.
Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates.
Assist Quality department with HEDIS measure deep dive to support HEDIS audit and revenue at risk reporting.
Calculate and track HEDIS rates for all intervention outcomes and for overall markets and LOB.
Work in an agile business environment to derive meaningful information out of complex as well as large organizational data sets through data analysis, data mining, verification, scrubbing, and root cause analysis.
Analyze data sets and trends for anomalies, outliers, trend changes and opportunities, using statistical tools and techniques to determine significance and relevance. Utilize extrapolation, interpolation, and other statistical methodologies to predict future trends in cost, utilization, and performance.
Act as a subject matter expert in HEDIS reporting and provide trainings as required. Stay current with NCQA standards and educate team as well as health plan analysts as needed.
Lead initiatives with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
Track, Facilitate and Manage changes in the Data warehouse platform and perform transparent upgrades to analytic reporting modules to ensure no impact to the end users.
Conduct preliminary and post impact analyses for any logic and source code changes for data analytics and reporting module keeping other variables as constant that are not of focus.
Develop training modules to help analysts understand processes, solutions or designs to meet the customer request for new/existing staff.
Provide technical, functional, and business trainings to internal and external team members to enable them to perform the required tasks.
Assist health plans building reporting solutions to perform successful member and provider interventions.
Qualification
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Required
Bachelor's Degree in Computer Science, Finance, Math or Economics or equivalent discipline
6+ Years of experience in working with data mapping, scrubbing, scrapping and cleaning of data.
6+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design
6+ years of experience in working with Microsoft T-SQL, SSIS and SSRS.
3+ years of experience with Microsoft Azure, AWS or Hadoop.
4+ Years of experience with predictive modeling in healthcare quality data.
4+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid, Marketplace and Medicare/MMP.
4+ Years of experience in working with increasingly complex data problems in quantifying, measuring, and analyzing financial/performance management and utilization metrics.
4+ Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions
Preferred
Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage.
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10,001+ employees
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (33)
2022 (36)
2021 (33)
2020 (60)
Funding
Current Stage
Public CompanyTotal Funding
$1.5B2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
2014-09-09Post Ipo Equity· $3.11M
Leadership Team
Dave Reynolds
Executive Vice President, Regional Health Plans
Debbie Simkins
Vice President, Office of the CIO
Recent News
2024-11-13
Company data provided by crunchbase
